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Hormone Replacement Therapy Q&A

1. Should I stop taking hormone replacement therapy (HRT)?

It depends on how long you’ve been taking it and why. Here are some facts to help you decide:

You may be taking HRT to relieve menopause symptoms. At one time, doctors also used to prescribe HRT to manage diseases like osteoporosis and heart disease in women past menopause. But in 2002, a Women’s Health Initiative study found that women who took the most common form of HRT, a combined estrogen and progesterone pill, had a higher risk of heart disease, stroke, and blood clots.

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HRT and Menopause Symptoms: Research shows that a small dose of HRT is still the best way to reduce uncomfortable symptoms in early menopause. Women younger than 60 have the lowest risks, especially if they use the estrogen-only formula for a short time, applying it to their skin instead of taking by mouth.

Several years of treatment is usually enough to relieve symptoms. So if you’ve been on HRT for more than 5 years, talk with your doctor about tapering off.

HRT and Heart Disease: Doctors no longer prescribe hormones to manage heart disease or other chronic conditions like osteoporosis. If you’re taking HRT to reduce the risk of heart disease, ask your doctor about gradually stopping it.

Before the WHI study, doctors prescribed HRT for heart problems. Some earlier studies  showed that women who took hormones had lower rates of heart disease and other chronic diseases. The women may have just been healthier and had better access to medical care.

The WHI study and follow-ups confirmed that HRT didn’t reduce the risk of heart disease; it increased it in healthy, postmenopausal women.

HRT and Osteoporosis: As with heart disease, you should weigh the benefits of using hormones with other risks. To reduce osteoporosis, doctors often suggest lifestyle changes such as regular weight-bearing exercise. You can also try medicine like Fosamax and Evista, or calcium and vitamin D supplements.

Or you may look at other choices, such as statins, which reduce cholesterol in the blood, but also treat osteoporosis and heart disease.

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